Population Health Specialist

Job Summary And Responsibilities

You have a purpose, unique talents and now is the time to embrace it, live it and put it to work. We value incredible people with incredible skills – but your commitment to a greater cause is something we value even more. This is the heartbeat of our organization and your time will be spent in a supportive, team environment with resources to help you flourish and leaders who care about your success.

The Population Health Specialist uses knowledge of HEDIS quality metrics to complete documentation gap closures for payer programs by using data collected in patient’s electronic medical records and or submitted from clinics. Identifies care gaps and distributes information to team members who will work with patients to coordinate care. Proactively requests patient records when the need is discovered and updates patient’s electronic medical records as applicable. Ensures timely data submission of information to payers. Tracks and reports gap closures and participates in prayer meetings. Develops and maintains training materials for quality programs and assists with clinic trainings as directed.

• Manually conducts review of patients’ medical records seeking evidence/supporting documentation of care gap completion.
• Accurately updates medical records with new record information and or when data is found not to be in discreate data fields as trained.
• Through internal payer attestation processes, conducts manual care gap closures for records that have been completed and adequately documented.
• Provide support and or education to the utilization of network platforms or electronic health records where primary care practices can review quality and utilization performance and pull patient rosters and gaps of care.
• Facilitate practice improvement utilizing lean methodologies and best practices.
• Collects, tracks, reports, and communicates data and data analyses as required. Develops quality training materials that align with NCQA guidelines.
• Provide training to internal resources and clinics on payer quality measures and programs.
• Develops trusting, working relationships with primary care providers and support teams.
• Uses current healthcare research findings and other evidence to expand clinical knowledge, enhance role performance, and increase knowledge of professional issues.
• Uses quality measures to improve performance and accountability for patient outcomes, patient experiences and safe delivery of care.
• Use multiple payer platforms for data exchange and patient research.
• Collaborate with internal associates and payer resources to manage patient attribution in payer contracts.
• Participate in payer meetings to learn about contract performance and report work efforts to improve contract performance.
• Uses information technology to communicate, manage knowledge, mitigate error and support decision-making
• Through chart reviews and observation , identify opportunities to improve current processes and workflows that will enable providers and care teams to focus on care provision and to provide the highest quality care to patient populations.
• Assists in the development and execution of scalable, evidence-based strategies to improve quality performance across the network.
  
  

Job Requirements

In addition to bringing humankindness to the workplace each day, qualified candidates will need the following:

• High School Diploma or GED required
• Bachelor Degree (in healthcare) preferred
• 2-3 years healthcare experience in an outpatient medical practice preferred.
• Proficient in use of computer applications, specifically Microsoft Office Products
• Experience with electronic medical records preferred.
• Experience with building training materials and training staff
• 1-2 years of experience with lean or six sigma methodologies
• Experience with payer quality programs preferred.
  
  

Where You'll Work

Located in Lakewood, Colorado, St. Anthony Hospital is a Level I Trauma Center where we provide a full range of medical specialties and health care services to Denver and the surrounding region through our state-of-the-art medical campus and home base for Flight For Life® Colorado. With four trauma rooms including the T-10 room, a dedicated field-to-surgery suite ready 24/7 for trauma surgeons and specially trained teams, our staff can provide life-saving care to the most severely ill and injured patients. In 2023, we received our exciting Magnet® designation! We are so proud of our staff for this achievement, which is awarded to only 10 percent of hospitals around the world. Numerous other awards, certifications, and accreditations have been granted to us from the American Heart Association; Chest Pain Center (CPC); American College of Cardiology; The Joint Commission’s National Quality Approval; the Emergency Nurses Association Lantern Award; NAPBC Accreditation; American College of Radiology and many others. At St. Anthony Hospital. We combine a heritage of expert care with the latest in technology and innovation. If you’re looking to be part of a fast-paced environment where you can practice to the top of your profession in trauma, cardiology, stroke, neurosciences, breast imaging, cancer/oncology care, surgery and more, we invite you to apply.

Pay Range

$20.13 - $30.65 /hour